Depression and Low Mood A self help guide

Funded by Western Bay Health and Social Care Programme This library of self help leaflets aims to help YOU be better informed about YOUR emotional health and wellbeing. Access to information is crucial as it helps people to take control, to know how to help themselves and how to get further advice, information or help if they need it. Your emotional health and wellbeing can be improved in different ways, from being able to access self help information, by talking to friends or simply by doing things we enjoy.

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Page How can this guide help me?

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What does research tell us about depression?

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Signs and symptoms you may experience if you are depressed?

5-6

How can I understand these feelings?

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Can I recognise these gloomy thoughts?

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What more should I know about gloomy negative thoughts?

10-14

How can I help myself?

15-22

Further help

22-23

Useful organisations

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Useful books

26-27

References

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These are the thoughts of two people who are depressed: “I feel so alone, I never see my friends now, now, II guess guess they they have have Theyprobably probablydon’t don’tlike likeme me––who whowould? would?There Thereis dropped me. They is no point in making any effort. It doesn’t off... I just hate no point in making any effort. It doesn’t paypay off... I just hate myself." “I feel like crying all the time, I am so tired and can’t get factI Idon’t don’teven evenget getstarted startedwith withjobs jobsI I interested in anything. InInfact should be doing, I can’t even do basic things that seem so easy to other people...”

You may have had similar thoughts yourself. Depression is a very common problem and many people feel low or down in the dumps at times. This is often due to life stresses such as bereavement, money or housing problems or difficulties in relationships. For some people the problem becomes much worse and gets in the way of normal life.

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How can this guide help me?

It may seem that nothing can be done to help you feel better. But there are things that you can do to make a difference. There is also further help you can get if the depression does not seem to be getting any better. This guide aims to help you cope with depression and begin to get better. The approach is called Cognitive Behaviour Therapy (CBT). CBT uses methods that have been tried and tested and found to be effective. It involves looking at the way you think about things and what you do. We have included pen and paper exercises in the booklet to help you begin to understand and begin to deal with depression practically. You should find it helpful to complete these exercises. For more general information on depression see our booklet ‘Depression – an information booklet’.

What does research tell us about depression?

Life is sometimes difficult and we know that factors such as low income, divorce or relationship problems and loss of work can make people more likely to become depressed. Research has helped us to understand depression more clearly. We now realise that thoughts can also play an important role in depression. Changes in feelings may occur gradually, but the way a person thinks about themselves when they are depressed is very different from how they thought before. Perhaps you can think about some examples of depressed thinking in yourself or in someone you know who has depression.

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Here are a few examples: x The successful business man who believes he is on the brink  of bankruptcy.  x The caring mother who thinks she has lost interest in her children. x The clever student who thinks he can’t concentrate and is  stupid. x The hard working man who thinks that he is useless because  he has lost his job.

People who are depressed typically have such thoughts and at the time they believe them to be true. When someone’s thoughts change like this, they also begin to experience other changes. These are some of the signs or symptoms that you may experience experience if if you you are are depressed: depressed:

(tick ifif you you feel feel like like this) this) Emotions or feelings -- (tick x Feeling sad, guilty, upset, numb or despairing   x Losing interest and/or enjoyment in things x Crying a lot or unable to cry when a truly sad  event occurs x Feeling alone even if you are in company   x Feeling angry and irritable about the slightest thing Physical or Bodily Signs x Tiredness  x Lack of energy  x Restlessness   x Sleep problems x Feeling worse at a particular time of day –  usually mornings x Changes in weight, appetite and eating 

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‰ ‰ ‰ ‰ ‰ ‰ ‰ ‰ ‰ ‰ ‰

Thoughts x Losing confidence in yourself  x Expecting the worst and having negative  or gloomy thoughts x Thinking that everything seems hopeless  x Thinking you hate yourself   x Poor memory or concentration x Thoughts of suicide 

‰ ‰ ‰ ‰ ‰

Behaviour  x Having difficulty in making decisions x Can’t be bothered to do everyday tasks  x Putting things off  x Not doing things you used to enjoy  x Cutting yourself off from other people 

‰ ‰ ‰ ‰ ‰

‰

If you have ticked many of these boxes then you may be experiencing low mood or depression. When you’re depressed you may believe that you’re helpless and alone in the world; you often blame yourself for all the shortcomings that you think you have. At the bottom of all this you feel negative about yourself, about the world and about the future. So you tend to lose interest in what’s going on around you and you don’t get any satisfaction out of the things you used to enjoy. It can become hard to make decisions or to carry out little tasks that you once did with no problem at all. In Summary Research now tells us that gloomy thoughts play an important important role in depression. When Whensomeone someoneisisdepressed depressedthere thereare are usually changes in the way they feel – their emotions, how their body reacts, what they think and how they behave.

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How can these feelings? How canI Iunderstand understand these feelings?

The way you think about things affects the way you feel, which affects the way you behave. It is difficult to change the way you feel, but you can change the way you think and the things you do. When you are feeling depressed you might have negative thoughts a lot of the time. With each negative thought the feelings of depression are likely to increase. Sometimes negative thoughts can stop you from doing the things that you would normally do. As a result, you may have critical thoughts about being lazy, or irresponsible, which make you feel even worse. In other words, you get caught up in a vicious cycle.

For example: Suppose you are walking down the street and you see a friend who appears to ignore you completely. completely. You Youmight mightwonder wonderwhy why your friend friend has has turned turned against against you you and and you you feel feel aa little little sad. sad. your Later on, you mention the incident to your friend, who tells you Later on, you mention the incident to your friend, who tells you that he was preoccupied at the time and he didn’t even see you. that he was preoccupied at the time and he didn’t even see you. Normally you you would would feel feel better better and and put put what what happened happened out out of of Normally your mind. But if you’re depressed, you probably believe your your mind. But if you’re depressed, you probably believe your friend has has rejected rejected you. you. You You may may not not even even ask ask him him about about the the friend incident, and then the mistake goes uncorrected. If you’re feeling incident, and then the mistake goes uncorrected. If you’re feeling depressed you’re more likely to make mistakes like this over and depressed you’re more likely to make mistakes like this over and over again. over again.

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The vicious cycle can look like this:

===Body

Actions

Has a similar cycle happened to you? Try Try and and draw draw itit out. out.

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Can I recognise these gloomy thoughts?

When you are feeling low the gloomy thoughts may be so familiar and happen so often to you that you just accept them as fact. Gloomy Gloomythoughts thoughts are often about yourself; for example:

Do you have any gloomy thoughts about yourself? –– jot jot them down: .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... ……………………………………………………………………….. ...................................................................................................

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These thoughts are sometimes about other things such as the world around you or the future. For example:

Do you have any gloomy thoughts about other things? -– jot them down: .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... ……………………………………………………………………….. ...................................................................................................

What more should I know about these gloomy thoughts? negative thoughts?

We have given examples of the negative thoughts people have when they are depressed. It is important to remember that you might still occasionally have some of these sorts of thoughts when you are not depressed. The difference is that you would generally dismiss them from your mind. When you are depressed, however, these thoughts are around all the time. Let's look at these negative thoughts in more detail:

1.

Negative thoughts tend to be automatic. They are not actually arrived at on the basis of reason and logic, they just seem to pop up out of the blue. 10

2.

Often the thoughts are unreasonable, and unrealistic. They serve no purpose. All they do is make you feel bad and they get in the way of what you really want out of life. If you think about them carefully, you will probably find that you have jumped to a conclusion which is not necessarily correct. For example, thinking someone doesn’t like you because they haven’t phoned recently.

3.

Even though these thoughts are unreasonable they probably seem believable and correct to you at the time.

4.

The more you believe and accept negative thoughts, the worse you are likely to feel. If you allow yourself to get into the grip of these thoughts, you find you are viewing everything in a negative way.

When people become depressed their thinking often changes. They may have some of the following unhelpful thinking styles when they are feeling depressed: Exaggeratingthe thenegative negative 1. Exaggerating This means we think things are much worse than they really are. For example you make a small mistake at work and fear that you may be dismissed because of it. In other words you jump to a gloomy conclusion and believe that it is likely to happen, or you may spend a long time worrying that you have upset a friend only to find later she didn’t even remember the comment. Do you ever exaggerate the negative? Think back over the last two weeks and please list: .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... ……………………………………………………………………….. ................................................................................................... 11

Overgeneralising 2. Overgeneralising This is when we generalise from one small thing. For example, if one person doesn’t get on with you, you may think “no one likes me” or if one of your many daily tasks hasn’t been finished you think “I’ve achieved nothing – nothing has been done”. In other words from one thing that has happened to you, you draw a negative conclusion which is much bigger and covers all sorts of things. Do you ever overgeneralise? Think back over the last 2 weeks and list examples: .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... ……………………………………………………………………….. ...................................................................................................

Ignoringthe thepositive positive 3. Ignoring People who are depressed tend to focus their thinking on negative or bad events and ignore positive or good events. For example, you might have had a game of pool and missed the shot once, but played well in general. After the game you just think about that one missed shot and not the rest of the game played well, or you may have many good friends who you have known for years but you concentrate and worry about one that has fallen out with you rather than remembering all the other good friendships.

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Do you you sometimes sometimes ignore ignore the the positive? positive? Do Jot down some examples from the last two weeks: .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... ……………………………………………………………………….. ...................................................................................................

Takingthings thingspersonally personallyand andbeing beingself selfcritical critical 4. Taking Often if our mood is low we blame ourselves for anything which goes wrong, even if things have nothing to do with us in reality. For example, you go into a local shop and the assistant who knows you is ‘off-hand’, your automatic thought is "she doesn’t like me... have I done something wrong?”, but the most likely reason is that she’s tired or upset or has had a ‘bad day’. In this example you have taken the blame personally. You may also be self critical and put yourself down with thoughts such as “I am an idiot”, “I never get things right”.

Do you sometimes take things personally when they probably have little to do with you? Are Areyou yousometimes sometimes self critical? Give Give some some examples examples from from the the last last two two weeks: weeks: .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... ……………………………………………………………………….. ...................................................................................................

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5. Mindreading Mindreading We sometimes believe we know what others are thinking and if our mood is low we may expect that they are thinking badly of us. For example if a new friend is quiet you may think “that is because she thinks I am boring”. find that you ‘mindread’? Do you find Jot down some examples from the last two weeks: ................................................................................................... .………………………………………………………………………. .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... ……………………………………………………………………….. ................................................................................................... In Summary When people are depressed they often have unhelpful thinking styles, leading to gloomy or unhelpful thoughts about themselves, the world and the future. They exaggerate the negative, overgeneralise bad events, ignore positives in their lives, things personally. personally. ItItisisimportant importanttoto lives, mindread mindread and and can can take take things uncover gloomy thoughts and unhelpful thinking styles. uncover gloomy thoughts and unhelpful thinking styles.

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How can I help myself?

So far we have talked about how what we think affects the way we feel. We have looked at particular ways of thinking which can lead to us getting depressed. In this section we will look at practical steps to help to overcome depressive feelings and thoughts. Research evidence tells us that increased activity is very helpful in overcoming depression.

Positive steps x  x  x  x  x 

List things to do Mix with people Join in activities Take exercise Do things you enjoy

1. Making Makingaadaily dailyplan plan

When people are depressed they often don’t feel like doing anything, find it hard to decide what to do each day and can end up doing very little. Begin to tackle this by making a list of things you want to do. Then plan out an action list, start off with the easiest task at first and don’t aim too high. Work through your action list and tick off what you’ve done. At the end of the day you’ll be able to look back and see what you’ve achieved. Physical exercise and activity can really help to lift your mood. Try and build a little in each day. Mixing with friends, family and neighbours can also help. 15

List some exercises or activities which you could do. This can be as simple as a brisk walk; or doing a crossword with a member of your family: .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... .………………………………………………………………………. ................................................................................................... ……………………………………………………………………….. ...................................................................................................

Try to fill in this action plan – continue with similar plans Mon

Tues

Wed

Thurs

9am – 11am 11am

11am – 1pm 1pm – 3pm 3pm – 5pm 5pm – 7pm

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Fri

Sat

Sun

2. Achievements Achievementsand andpleasure pleasure

When people are depressed they often forget what they’ve achieved and what they enjoy. Most people have more things going for them than they are usually aware of. On your daily action plan write down all events of the day, put a P next to those which have given you pleasure and an A next to those activities where you felt you achieved something and did well. Try not to be too modest; people who are depressed tend not to take credit for their achievements. Try and build some pleasant events into your day each day - treat yourself, it will help you.

3. The TheABC ABCof ofchanging changingfeelings feelings

Most people who are depressed think their lives are so awful that they have every right to feel sad. In fact our feelings come from what we think about and how we make sense of what has happened to us. Try to think about a recent event which had upset and depressed you. You should be able to sort out three parts of it: A. B. C.

The event. Your thoughts about it. Your feelings about it.

Most people are normally only aware of A and C.

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Let's look at an example: Suppose someone at work criticises you for a piece of work you have done. A. B.

The event – criticism of your work. Your thoughts – what are you thinking about? You may need to concentrate to discover this.

C.

Your feelings – hurt, embarrassed.

How depressing! No wonder you feel bad! The important point about trying to become aware of these three stages A, B and C is that we can change what we think about an event and therefore we can change how we feel about it.

Balancing 4. Balancing

A useful technique to try is called balancing. When you have a negative, critical thought, balance it out by making a more accurate and positive statement to yourself. For example: The thought: “I’m no good at my job”, could be balanced with: “my boss said how much he appreciated the piece of work I did yesterday”.

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5. The Thedouble doublecolumn columntechnique technique

Another thing you could do is write down your negative automatic thoughts in one column – and, opposite each one, write down a more balanced positive thought. Like this: Negative automatic thought: Balancing thought: John hasn’t called, he doesn’t like me.

He is very busy and thinks I am doing better than I was last week, so he doesn’t need to worry about me.

Later, it may be helpful to keep a diary of events, feelings and thoughts. Try to keep a diary of events, feelings and thoughts. It may look a bit like the table overleaf. Use the approaches described to gain more balanced thoughts. Look out for unhelpful thinking styles. Event Example A neighbour ignored me

Feeling or emotion

Thoughts in Other Other more more your mind balanced thoughts thoughts balanced

Low and depressed

She doesn’t like me, no one does.

Your example

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She’s probably got something on her mind – I am jumping to a conclusion that she doesn’t like me.

6. Try Tryand andremember rememberdetails details

Research tells us that the person who is depressed doesn’t remember details of events but tends to think in general statements, such as “I’ve never been any good at anything”. Try and train yourself to remember specific details so that good times and experiences are easy to recall. A daily diary can help you to do this. Make lists of actual achievements and good aspects of yourself such as “I’m always on time”, “I helped my friend on Tuesday” or “My partner complimented me on my work last week”. Listing past achievements and pleasurable activities in detail can also be helpful. In Summary Using a daily plan, mastery and achievement notes and keeping a diary of automatic thoughts and more balanced thoughts can help you to fight fight depression and the gloomy thoughts that go with it.

7. Solving Solvingdifficult difficultproblems problems

Sometimes we feel overwhelmed by the very complicated and difficult things we have to do. One thing which helps with this sort of problem is to write down each of the steps which you have to take in order to complete the job – then tackle one step at a time. Problem solving can seem more difficult when you feel depressed. If you have a particularly difficult problem, try and look back to times when you may have successfully solved similar problems and use the same approach. Or ask a friend what they would do in a similar situation. Be clear. Write down all your possible options. Use ‘brainstorming’ – where even apparently silly solutions are written down to be considered. Choose the best approach.

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Try this way of problem solving yourself. What is the problem? (write it down – be as specific specific as possible): ............................................................................................... .…………………………………………………………………… .…………………………………………………………………… ............................................................................................... .…………………………………………………………………… ............................................................................................... .…………………………………………………………………… ............................................................................................... .…………………………………………………………………… ............................................................................................... .…………………………………………………………………… ............................................................................................... Try the following: List all sorts of solutions (brainstorming). Remember Rememberhow how you may have solved similar problems in the past. What would your friends advise? Or how would you advise a friend with a similar problem. .…………………………………………………………………… ............................................................................................... .…………………………………………………………………… ............................................................................................... .…………………………………………………………………… ............................................................................................... .…………………………………………………………………… ............................................................................................... .…………………………………………………………………… ............................................................................................... .…………………………………………………………………… ............................................................................................... Choose the best of the above. (write it down) .…………………………………………………………………… ............................................................................................... .…………………………………………………………………… ............................................................................................... .…………………………………………………………………… ............................................................................................... .…………………………………………………………………… ............................................................................................... .…………………………………………………………………… ...............................................................................................

Steps to tackle it: Step 1: …………………………………………………………… ................................................................................... ................................................................................... Step 2: ……………………………………………………………

Step 3: …………………………………………………………… ................................................................................... Step 4: …………………………………………………………… ................................................................................... Step 5: ................................................................................... …………………………………………………………… 21

8. Long Longterm termbeliefs beliefs

Sometimes people have long held views about themselves that are very self critical – for example, “I’m not a very clever person” or “I’m not a very lovable person”. These beliefs are often a product of our past experience and may hold no truth in present reality. Try to challenge this self criticism, stop knocking yourself down and look for evidence that disproves the beliefs. What would you say to a good friend if they held that belief about themselves?

9. Particularly Particularlystressful stressfultimes times

Many people experience a difficult time in their lives which can be linked with events that they cannot change, for example bereavement, or several bereavements over a short period, unemployment, longstanding illness, chronic financial problems or isolation. Sometimes several of these events happen together and depression can result. In time, most people bounce back, but it may be hard to do this without help.

10. Further Furtherhelp help

We hope you will use the exercises suggested in this booklet. They should help you to begin to overcome your depression and get back in control of your thoughts and your life. If you feel that you are making little progress then other help is available to aid you in overcoming your problem. Your family doctor is the best person to talk to first. They may suggest a talking treatment or antidepressant tablets or both. They may suggest you see a mental health worker who can offer expert help with your problems. If you feel so depressed that thoughts of harming yourself have been in your mind then visit your doctor as soon as possible and talk about how you are feeling.

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Where can I find find extra help?

If you think you may be depressed, your GP is the best person to talk to in the first instance. They will have information about local services which may be able to help. Help may also be obtained from your practice nurse or health visitor based at your GP practice.

Useful organisations Find your local doctors surgery by visiting http://www.wales.nhs.uk/sitesplus/863/directory/gps/ or visit www.nhsdirect.wales.nhs.uk To find out more about how to ACTivate your life in 2015, the ABMU living life well programme could be for you. Email: [email protected] or phone/text: 07967 612246. ACTivate Your Life is a four session course which aims to help you to have a better life, a life with less suffering and greater freedom to do the things that matter to you. The All Wales Veterans Mental Health Service operates across our counties and provide support to all ex service men. Visit www.veteranswales.co.uk for up to date details. Bibliotherapy - Book Prescription Wales provides a list of specially selected self help books, as recommended by psychologists and counsellors. Your GP can talk you through this and see what is suitable for you. Bipolar Wales provide peer support groups, mentoring services and awareness campaigns to enable people affected by Bipolar to take control of their lives. Visit www.bipolaruk.org.uk/wales or ring 01633 244244 for further details about local groups. CALL – COMMUNITY ADVICE AND LISTENING LINE: 0800132 737 / 0845 6023694. A free, confidential helpline for listening, support and health/mental health info.

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Carers Centres across the region support carers in all situations. Bridgend - 01656 658479; Neath Port Talbot - 01639 642277; Swansea - 01792 653344. Computerised Cognitive Behavioural Therapy (CCBT) is a self help programme to help individuals understand and teach effective ways to manage anxiety and low mood. Two free and easy to use CCBT include:www.livinglifetotheful.com and www.moodgym.anu.edu.au For counselling information and to find a local practitioner near you, visit www.bacp.co.uk or 01455 883 300 Cruse Bereavement Care provide direct support to anyone affected by the loss of another. Call 01792 462845. DASH exists to reduce harm to people affected by substance misuse. Visit www.ogwrdash.org.uk or call 01656 650686. Fathers reaching out raise awareness around the impacts that Post natal depression has on both fathers and families. Visit www.fathersreachingout.com or call 07472 959889 / 07533 522405 for further information. GOFAL provide a wide range of services to people with mental health problems, supporting their independence, recovery, health and wellbeing. Visit www.gofal.org.uk for further information or call the head office on 01656 647722. HAFAL support individuals and families suffering from severe mental illness. To find out about your local HAFAL branch visit www.hafal.org or call head office on 01792 816600. Mindfulness Based Cognitive Therapy is an 8 week programme that is designed specifically for people who have repeated bouts of depression. For further information visit www.mbct.co.uk

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Mental Health Matters Wales provide a range of services for people suffering with mental ill health – counselling, tenancy support, befriending, information and training. Call 01656 651450 or visit www.mhmbcb.com PANDAS is the leading UK charity in supporting families suffering from antenatal and postnatal depression. Visit www.pandasfoundation.org.uk or call 0843 28 98 401 Peer support is often a really effective way of getting hints and tips to move towards recovery. These peer support group exist in all local mental health services, additionally there are service user groups in each area:Bridgend – SUN group – 01656 732085 Swansea Patients Council and Swansea Network of User Groups - 01792 516627 Neath Port Talbot – SUN group – 01639 631246 Relate Cymru offer support with marital and relationship problems. Call 01792 480088 or visit www.relatecymru.org.uk for further information. The Samaritans provide a confidential listening line for anyone experiencing emotion distress. Call the 24hr helpline: 08457 90 90 90, email: or visit www.samaritans.org Young Minds are a national charity that provide information for young people and their families affected by Mental Ill Health. Call 0808 802 5544 or visit www.youngminds.org.uk Visit www.mentalhealth.org.uk and click on the A-Z to see how things such as Diet and exercise can affect your mental health.

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For a wider list of local well being and support networks associated with health, social care and well being contact your local County Voluntary Council in:Bridgend - 01656 810400 or visit www.bavo.org.uk Neath Port Talbot - 01639 631246 or visit www.nptcvs.com Swansea - 01792 544000 or visit www.scvs.org.uk County Voluntary Councils offer volunteering opportunities and wide access to local voluntary organisations operating in your communities.

Useful books x

Feeling good: the new mood therapy David Burns HarperCollins 2000 A drug-free guide to curing anxiety, guilt, pessimism, procrastination, low self-esteem, and other depressive disorders. Uses scientifically tested methods to improve mood and stave off the blues.

x

Overcoming depression: a guide to recovery with a edition) complete self-help programme (3rd (3rd edition) Paul Gilbert Constable and Robinson 2009 A self-help guide using Cognitive Behavioural Techniques, this book is full of step-by-step suggestions, case examples and practical ideas for gaining control over depression and low mood.

x

nd Dealing with depression (2 revised (2nd revisededition) edition) Kathy Nairne and Gerrilyn Smith The Women’s Press 1998 This is a practical guide for sufferers of depression and those who know someone who is depressed. It identifies the causes of depression and the many forms it may take, explores ways of coping and recovering, and evaluates the help available.

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 x

Depression: the way out of your prison Dorothy Rowe Taylor and Francis 2003 Gives us a way of understanding our depression which matches our experience and which enables us to take charge of our life and change it.

 x

Mind over mood Christine Padesky and Dennis Greenberger. Guilford 1995 Draws on the authors' extensive experience as clinicians and teachers of cognitive therapy to help clients successfully understand and improve their moods, alter their behaviour, and enhance their relationships.

x 

Overcoming depression and low mood: a five five areas rd (3rd revisededition) edition) revised approach (3 Chris Williams Hodder Education 2012 Fully updated and based on extensive feedback, Overcoming Depression and Low Mood is a series of short self-help workbooks for use by people experiencing low mood and depression. Developed in liaison with a wide range of experts, the course provides access to the proven Cognitive Behaviour Therapy (CBT) approach. Providing accessible information and teaching key life skills the workbooks provide a practical and effective way of improving how you feel.

x 

Anxiety and depression: a practical guide to recovery Robert Priest Ebury Press 1996 Robert Priest has written this book especially to provide help for those feeling anxious and depressed. In particular, he covers the practical self-help methods to reduce stress and offers an explanation of the causes and effects of anxiety and depression.

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References

x 

x 

x  x  x 

x 

Depression: The treatment and management of depression in adults. NICE clinical guideline 90. National Institute for Health and Clinical Excellence. October 09 The six cycles maintenance model; Growing a ‘Vicious Flower’ for depression. Moorey, S. 2010, Behavioural and Cognitive Psychotherapy. 38 pp 173-184 Cognitive therapy and the Emotional Disorders. Beck A.T. 1976 New York Guildford Press Overcoming Depression: A self help guide using cognitive behavioural techniques. Gilbert, P. 2000 Robinson Press. Rumination and prospective changes in depressive symptoms. Grassia, M. and Gibb, B.E. 2008 Journal of social and Clinical Psychology, 27, pp 931-948 Contemporary behavioural activation treatments for depression: procedures, principles and progress. Hopko, D.R., Lejuez, C.W., Ruggiero, K.J. and Eifert, G.H. 2003 Clinical psychology Review, 23, 699-717

Written by Dr Lesley Maunder and Dr Lorna Cameron, Consultant Clinical Psychologists, The Newcastle upon Tyne Hospitals NHS Foundation Trust. This guide has been developed from an earlier manual by Sheila Sharkey and Kevin Gibson. Many thanks to voluntary sector groups, service users and healthcare staff in Northumberland, Tyne and Wear who have contributed to the review of this guide. This leaflet is reproduced with permission from Northumberland, Tyne and Wear NHS Foundation Trust © 2013 www.ntw.nhs.uk A certified producer of reliable health and social care information www.informationstandard.org

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